Embargoed AJPH Research: Mental Health Services in the Military, Older Adults’ Risk of Falls, Mother’s Depression and Homelessness

Released: 14-Jul-2014 10:00 AM EDT
Embargo expired: 17-Jul-2014 4:00 PM EDT
Source Newsroom: American Public Health Association (APHA)
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Available for logged-in reporters only

EMBARGOED UNTIL July 17, 2014 4 p.m. (EDT)


Contact: For copies of articles or full table of contents of this month’s released studies, call Kimberly Short, 202-777-2511, or email Kimberly.Short@apha.org.


American Journal of Public Health highlights:
1. U.S. soldiers’ use of mental health services increases, stigma decreases
2. For older adults, walking to shop or complete errands shows greater risk of falls than recreational walking
3. Depression during a mother’s postpartum year linked to homelessness risk


U.S. soldiers’ use of mental health services increases, stigma decreases
New research from the American Journal of Public Health finds an increase in U.S. military soldiers’ use of mental health services and a decrease in perceived mental health stigma over the course of recent wars from 2002 to 2011.
Using data from the Health-Related Behavior surveys of the Department of Defense and Land Combat surveys, which collectively spanned the years of 2002-2011, researchers reviewed the responses of active-duty military personnel regarding their use of mental health services. Stigma surrounding mental health was also assessed through a range of survey questions including level of embarrassment, trust in mental health professionals and effects on one’s career.
Results from the study indicate that between the years of 2003 and 2011, there was a 94 percent increase in the utilization of mental health services. Further, the study found a decrease in the number of soldiers associating stigma with use of mental health services. Despite the increase in use of services and decrease in stigma, results also found that two-thirds of soldiers who screened positive for mental health problems did not seek mental health care prior.
“This is the first study, to our knowledge, to empirically examine trends in mental health services utilization as well as stigma among active-component U.S. soldiers over the course of the wars. Significant efforts have been made to increase mental health services utilization and reduce mental health-related stigma in the U.S. Army,” the researchers explained.
“To conclude, we must caution that stigma remains a pervasive problem, particularly concerning trust levels of mental health providers, and approximately six of every 10 soldiers meeting self-reported criteria for PTSD, [depression] or PTSD and [depression] are not utilizing mental health services,” they write.
[“Trends in mental health services utilitarian and stigma in U.S. soldiers from 2002 to 2011,” Contact: Phillip Quartana, PhD, Walter Reed Army Institute of Research, Silver Spring, Maryland, phillip.j.quartana2.civ@mail.mil].


For older adults, walking to shop or complete errands shows greater risk of falls than recreational walking
Older adults who walk for the purpose of shopping and completing errands are more likely to experience a higher rate of outdoor falls than those who walk for the purpose of recreation, according to a new study from the American Journal of Public Health.
Using data from the MOBILIZE Boston study, which identified risk factors in falls among men and women approximately 70 years of age or older, researchers analyzed interactions between walking habits, neighborhood socioeconomic status and outdoor fall incidence. The study, in particular, reviewed the fall occurrences of older adults who walked for utilitarian purposes, that is, to shop and complete necessary errands, compared to those who walked for recreational purposes.
Results from the study indicate that older adults who predominantly walk for utilitarian purposes experienced a greater rate of outdoor falls compared to those who walked recreationally only. In addition, lower socioeconomic neighborhoods were associated with a greater incidence of utilitarian walking. Higher rates of falls on sidewalks, streets and curbs were also associated with lower socioeconomic status neighborhoods.
“When considering municipal initiatives to improve the safety of walking environments, not only recreational paths and public parks but also areas where older people shop and do other errands of necessity should be taken into account. Falls prevention requires attention to both socioeconomic and built environment conditions, particularly in neighborhoods with high concentrations of older residents,” the researchers conclude.
[Utilitarian walking, neighborhood environment and risk of outdoor falls among older adults,” Contact: Wenjun Li, PhD, Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, wenjun.li@umassmed.edu].

Depression during a mother’s postpartum year linked to homelessness risk
A new study from the American Journal of Public Health finds a strong association between depression during a mother’s postpartum year and subsequent homelessness and risk for homelessness.
The study reviewed interview responses and medical records regarding depressive symptoms and homelessness status among 2,974 mothers before and after birth. Data collected were a part of the Fragile Families and Child Wellbeing Study that randomly selected birth logs from 75 hospitals in 20 U.S cities with populations over 200,000.
The study found that 13 percent of the women experienced depression during their postpartum year. Even among women who had no personal or family history of mental illness, depressive symptoms or housing insecurity, the researchers found a strong association between depression during the postpartum year and homelessness or risk of homelessness two to three years later.
“Overall our study provides robust evidence that maternal mental illness places families with young children at risk for homelessness, adds to the scant literature that elucidates directional and causal links between mental illness and homelessness, and contributes to a largely stagnant but important body of literature on family homelessness,” the researchers explain.
[“Maternal depression as a risk factor for family homelessness,” Contact: Marah Curtis, PhD, School of Social Work, University of Wisconsin, Madison, Wisconsin, mcurtis3@wisc.edu].

Find a full list of research papers to be published online on July 17, 2014 at 4 p.m. EDT below:
• Retention in care and viral suppression among persons living with HIV in New York City, 2006-2010
• Utilitarian walking, neighborhood environment and risk for outdoor falls among older adults
• Do new walking and cycling routes increase physical activity? One- and two-year findings from the UK iConnect study
• The impact of public housing on social networks: a natural experiment
• Environmental conditions within low-income urban housing: Clustering and associations with self-reported health
• Recent violence in a highly co-morbid community-based sample of homeless and unstably housed women
• Maternal depression as a risk factor for family homelessness
• Suicides associated with eviction and foreclosure increased during the U.S. housing crisis: Findings from 16 NVDRS states, 2005-2010
• Is the Polytrauma Clinical Triad associated with suicide-related behavior among veterans of Iraq and Afghanistan? A national cohort study
• Trends in mental health services utilization and stigma in U.S. soldiers from 2002 to 2011
• The effect of cognitive therapy on structural social capital: Results from a randomized controlled trial among sexual violence survivors in the Democratic Republic of Congo
• Denial of abortion due to provider gestational age limits in the United States
• Prevalence of undiagnosed acute and chronic HIV in a lower prevalence urban emergency department
• HIV diagnoses among men who have sex with men and women - United States and 6 dependent areas, 2008-2011
• Online social network changes in an HIV prevention RCT for African American and Latino men who have sex with men
• Seroprevalence of HIV, HBV, and HCV among injection drug users in Connecticut: Understanding infection and co-infection risks in a non-urban population
• Assessment of hepatitis C risk factors and infection prevalence in a jail population
• Older jail inmates and community acute care use
• Determinants of mental health and self-rated health: A model of socioeconomic status, neighborhood safety, and physical activity
• Exploring risk factors in Latino cardiovascular disease: The role of education, nativity and gender
• Community characteristics and mortality: The relative strength of association of different community characteristics
• Child protection and adult mortality: Evaluating the Finnish policy of evacuating children to foster care during World War II
• Assessing the connection between health and education: Identifying potential leverage points for public health to improve school attendance
• Medicaid enrollment gap length and number of Medicaid enrollment periods among US children
• Role of health insurance on the survival of infants with congenital heart defects
• Insurance continuity and Human Papillomavirus Vaccine uptake in Oregon and California federally-qualified health centers
• Effect of acculturation on variations in having a usual source of care in Asian Americans versus non-Hispanic whites in California
• Age at menarche: 50 year socioeconomic trends among US-born black and white women, 1959-2008
• Characterization of dementia and Alzheimer disease in an older population: Updated incidence and life expectancy with and without dementia
• Mortality risks among persons reporting same-sex sexual partners: Evidence from the 2008 General Social Survey—National Death Index Dataset
• Caloric beverage intake among adult Supplemental Nutrition Assistance Program participants
• A "maintain, don't gain" approach to weight management reduces depression among Black women: Results from a randomized controlled trial
• The cost-effectiveness of school-based eating disorders screening
• Mortality and economic costs from regular cigar use in the United States, 2010
• Circulating 25-hydroxyvitamin D and vitamin D intake are unrelated to incidence of kidney stones
• Statistics at the forefront of public health analysis and reporting

The articles above will be published online July 17, 2014, at 4 p.m. (EDT) by the American Journal of Public Health® under “First Look” at http://www.ajph.org/first_look.shmtl. “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, www.apha.org, and is available at www.ajph.org.
The American Journal of Public Health ® is the monthly journal of the American Public Health Association. APHA champions the health of all people and all communities by strengthening the profession of public health, sharing the latest research and information, promoting best practices and advocating for public health issues and policies grounded in research. More information is available at www.apha.org.

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to Kimberly Short at APHA, 202-777-2511, or via email, Kimberly.Short@apha.org. A single print issue of the Journal is available for $35 from the Journal’s Subscriptions department at www.ajph.org/subscriptions. If you are not a member of the press, a member of APHA or a subscriber, online single issue access is $30 and online single article access is $22 at www.ajph.org or for direct customer service, call 202-777-2516, or email ajph.subscriptions@apha.org.

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